From the Research
The ICD-10 codes that typically meet medical necessity for CT coronary calcium scoring include Z13.6, I25.10, Z82.49, E78.0-E78.5, and I10, as supported by the most recent study 1. These codes are used to assess cardiovascular risk in asymptomatic patients with intermediate risk factors or family history of heart disease. The test quantifies calcium deposits in coronary arteries, which correlate with atherosclerotic plaque burden and help predict future cardiovascular events. Some key points to consider when using these codes include:
- Z13.6 is used for encounter for screening for cardiovascular disorders
- I25.10 is used for atherosclerotic heart disease of native coronary artery without angina pectoris
- Z82.49 is used for family history of ischemic heart disease and other diseases of the circulatory system
- E78.0-E78.5 is used for disorders of lipoprotein metabolism
- I10 is used for essential hypertension Additional qualifying codes may include:
- Z87.891 for personal history of nicotine dependence
- E11.9 for type 2 diabetes without complications
- R07.9 for chest pain, unspecified It's essential to verify specific coverage requirements with the patient's insurance provider before ordering the test, as some consider it preventive screening and may not provide coverage 1.